Abstract

Introduction: Genetic and environmental factors have a major influence on the pathophysiology of inflammatory bowel disease (IBD). Older studies reported a very low prevalence of IBD among the Arab population in Israel. Objective: Evaluate the current prevalence and disease characteristics of IBD in the Israeli-Arab population and to compare them to the Jewish population in the same area. Methods: Electronic medical records of all patients insured in the Sharon- Shomron district of Clalit Health Services were reviewed until December 2012. Files of all adults (> 18 years) with a diagnosis of IBD were retrieved. Results: 616,338 patients were insured in the district - 185,510 Arabs and 430,828 Jews. 2050 Jewish and 263 Arab patients met the criteria for IBD (prevalence of 0.48% and 0.14% respectively, p < 0.001). Arab patients were younger at diagnosis (35.6 ± 16.2 vs. 41 ± 18.8y, p < 0.001), had more exacerbations (58.6% vs. 39.5%), anemia (52.1% vs. 39.5%), hypoalbuminemia (33.5% vs. 25.7%) and hypocholesterolemia (53.6% vs. 44%) (all p < 0.01). The Arab patients received more oral steroids (46% vs. 36%, p < 0.01). More Jewish patients underwent colonoscopy and bone densitometry (43% vs. 32% and 20% vs. 12%, respectively, p < 0.01). Arab patients had more IBD-related hospitalizations (37% vs. 28%, p < 0.01), but had the same rate of IBD- related surgery compared to the Jewish patients. Conclusions: Prevalence of IBD among the Israeli-Arab population is increasing, but remains lower than among the Jewish population. Arab patients are younger and have more active disease. Our findings support the central role of genetic and environmental factors in the phenotypic expression of IBD, while underscoring ethnic and cultural differences.

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